Individual provider Active NPI

Dara Pitts, PA-C

  • Physician Assistant
  • Parker, CO
National Provider Identifier
1508374018
Registry record updated Jan 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0005251 Issued in CO
Practice address
9399 Crown Crest Blvd
Parker, CO 80138-8506
Phone
(720) 279-9098
NPI assigned
Jan 18, 2018
Last updated
Jan 28, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0005251 CO Primary

Addresses

Primary practice location

9399 Crown Crest Blvd
Parker, CO 80138-8506

Mailing address

4895 Riverbend Rd
Boulder, CO 80301-2640
Phone (720) 279-9098

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180215001346 CO Practitioner - Physician Assistant 6305106113 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Elan Sleep LLCGroup PAC ID 8426587742, 20 clinicians

Practice addresses (Care Compare)

1630 Dry Creek Dr
Longmont, CO 80503-6422
Phone (720) 279-9098

1630 Dry Creek Dr
Suite 200
Longmont, CO 80503-6405

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0005251COMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Creekside Physical Medicine PLLC PastSince Oct 11, 2020 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: dara.pitts.1@31554.direct.athenahealth.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1516233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580169600000",
    "number": "1508374018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4895 RIVERBEND RD",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803012640",
            "telephone_number": "720-279-9098",
            "fax_number": "720-540-4250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9399 CROWN CREST BLVD",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801388506",
            "telephone_number": "720-279-9098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PITTS",
        "first_name": "DARA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-18",
        "last_updated": "2020-01-28",
        "certification_date": "2020-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "0005251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Parker, CO

Sources for this page

Verify at the official NPI Registry.